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@article{Kelleher:2021:10.1111/cea.13847,
author = {Kelleher, MM and Cro, S and Van, Vogt E and Cornelius, V and Lodrup, Carlsen KC and Ove, Skjerven H and Rehbinder, EM and Lowe, A and Dissanayake, E and Shimojo, N and Yonezawa, K and Ohya, Y and Yamamoto-Hanada, K and Morita, K and Cork, M and Cooke, A and Simpson, EL and McClanahan, D and Weidinger, S and Schmitt, J and Axon, E and Tran, L and Surber, C and Askie, LM and Duley, L and Chalmers, JR and Williams, HC and Boyle, RJ},
doi = {10.1111/cea.13847},
journal = {Clinical and Experimental Allergy},
pages = {402--418},
title = {Skincare interventions in infants for preventing eczema and food allergy: A cochrane systematic review and individual participant data meta-analysis},
url = {http://dx.doi.org/10.1111/cea.13847},
volume = {51},
year = {2021}
}

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TY  - JOUR
AB  - ObjectiveEczema and food allergy start in infancy and have shared genetic risk factors that affect skin barrier. We aimed to evaluate whether skincare interventions can prevent eczema or food allergy.DesignA prospectively planned individual participant data metaanalysis was carried out within a Cochrane systematic review to determine whether skincare interventions in term infants prevent eczema or food allergy.Data sourcesCochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase and trial registries to July 2020.Eligibility criteria for selected studiesIncluded studies were randomized controlled trials of infants <1 year with healthy skin comparing a skin intervention with a control, for prevention of eczema and food allergy outcomes between 1 and 3 years.ResultsOf the 33 identified trials, 17 trials (5823 participants) had relevant outcome data and 10 (5154 participants) contributed to IPD metaanalysis. Three of seven trials contributing to primary eczema analysis were at low risk of bias, and the single trial contributing to primary food allergy analysis was at high risk of bias. Interventions were mainly emollients, applied for the first 3–12 months. Skincare interventions probably do not change risk of eczema by age 1–3 years (RR 1.03, 95% CI 0.81, 1.31; I2=41%; moderate certainty; 3075 participants, 7 trials). Sensitivity analysis found heterogeneity was explained by increased eczema in a trial of daily bathing as part of the intervention. It is unclear whether skincare interventions increase risk of food allergy by age 1–3 years (RR 2.53, 95% CI 0.99 to 6.47; very low certainty; 996 participants, 1 trial), but they probably increase risk of local skin infections (RR 1.34, 95% CI 1.02, 1.77; I2=0%; moderate certainty; 2728 participants, 6 trials).ConclusionRegular emollients during infancy probably do not prevent eczema and probably increase local skin infections.
AU  - Kelleher,MM
AU  - Cro,S
AU  - Van,Vogt E
AU  - Cornelius,V
AU  - Lodrup,Carlsen KC
AU  - Ove,Skjerven H
AU  - Rehbinder,EM
AU  - Lowe,A
AU  - Dissanayake,E
AU  - Shimojo,N
AU  - Yonezawa,K
AU  - Ohya,Y
AU  - Yamamoto-Hanada,K
AU  - Morita,K
AU  - Cork,M
AU  - Cooke,A
AU  - Simpson,EL
AU  - McClanahan,D
AU  - Weidinger,S
AU  - Schmitt,J
AU  - Axon,E
AU  - Tran,L
AU  - Surber,C
AU  - Askie,LM
AU  - Duley,L
AU  - Chalmers,JR
AU  - Williams,HC
AU  - Boyle,RJ
DO  - 10.1111/cea.13847
EP  - 418
PY  - 2021///
SN  - 0954-7894
SP  - 402
TI  - Skincare interventions in infants for preventing eczema and food allergy: A cochrane systematic review and individual participant data meta-analysis
T2  - Clinical and Experimental Allergy
UR  - http://dx.doi.org/10.1111/cea.13847
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000621491800001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://onlinelibrary.wiley.com/doi/10.1111/cea.13847
UR  - http://hdl.handle.net/10044/1/86962
VL  - 51
ER  -

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